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Background: the objective of this study was to characterize the predisposing factors for intraoperative femur fracture during primary total hip arthroplasty. Methods: from 1999 to 2010, 28 fractures occurring during 1943 primary total hip arthroplasties were analyzed, an incidence of 1.4%. Vancouver classification was used. The presence of predisposing factors, their treatment and clinical and radiological outcomes were evaluated. Results: twenty three (82.1%) fractures were type A and 5 (17.9%) were type B. The average of the cervical-shaft angle was 140° (120°-160°). 71.4% were women and 7.1% had previous osteosynthesis. The incidence was 3.54% (16/452) in cementless femoral stems and 0.8% in cemented femoral stems (12/1491). Intraoperative treatments were: cerclage wire in 18 cases (64.3%), metal mesh plus cerclage wire in one patient (3.6%) and conservative treatment in 9 patients. Twenty seven (96.4%) patients obtained good results and the average Harris Hip Score was 93 points (89-95). Conclusions:  female patients, high cervical-shaft angle, hip dysplasia, cementless femoral stems and femur weakness after removing the osteosynthesis, are predisposing factors for this type of complication. For this reason, we suggest to perform a prophylactic cerclage wire when two o more of these predisposing factors are present.

revista de la asociación argentina de ortopedia y traumatología

Factores predisponentes de fractura intraoperatoria de fémur en artroplastia total de cadera primaria. [Predisposing factors for intraoperative femur fracture in primary total hip arthroplasty]